Evidence map›Paper›PMID 41363248›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Pulsed field ablation for atrial fibrillation ablation: a European Heart Rhythm Association survey.

Marco Bergonti, Mark T Mills, Laurent Roten, Martin H Ruwald, Andreas Metzner, Giulio Conte, Maura M Zylla, Konstantinos Vlachos, Michal Mazurek, Laura Perrotta and 4 more

Abstract read
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pulsed field ablation for the interventional treatment of atrial fibrillation: a scientific statement of the European Heart Rhythm Association of the European Society of Cardiology, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society, and the Canadian Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Guideline
  2. Safety and efficacy of intracardiac echocardiography in atrial fibrillation ablation: a meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Pooled it
  3. Pulmonary vein isolation durability in a randomized trial comparing fluoroscopy-only vs. electroanatomic mapping strategies for pulmonary vein isolation with balloon-in-basket pulsed-field ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  4. Pulsed field or cryoballoon ablation for paroxysmal atrial fibrillation-insights from acute and chronic electroanatomic remapping in the randomized SINGLE-SHOT CHAMPION trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  5. Article
  6. Article
  7. Article
  8. Incremental value of electroanatomical mapping during pentaspline pulsed field pulmonary vein isolation: the MAP-PFA pilot randomized trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  9. Management of recurrent atrial fibrillation after catheter ablation: 5-year outcomes of repeat catheter ablation vs. antiarrhythmic therapy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  10. Artificial intelligence-intracardiac echocardiography-guided pulsed field ablation of atrial fibrillation with variable-loop circular catheter.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  11. Pulsed field atrial fibrillation ablation with variable loop circular catheter: outcomes from large US registry.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  12. Algorithm-guided personalized pulsed field ablation for persistent atrial fibrillation: a prospective multicentre study with matched external comparison.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  13. Acute incomplete pulmonary vein isolation and unintended posterior wall ablation during pulsed field ablation: insights from high-density mapping.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  14. Article
  15. Pulsed field ablation for pulmonary vein isolation with or without posterior wall ablation in patients with persistent atrial fibrillation: a multicenter study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  16. Single-shot ablation for AF: Real-world procedural and one-year outcomes with the newly adopted PulseSelect PFA compared with cryoballoon from the 1STOP project.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  17. Diversity, equity, and inclusion in arrhythmia care: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  18. Effectiveness of AF pulsed field ablation with a variable-loop circular catheter: 12-month VARIPURE results.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  19. Impact of catheter design on lesion dimensions during focal-bipolar pulsed field ablation: an in vitro potato model study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  20. Circulating miR-10b-5p as a candidate biomarker of atrial fibrillation recurrence after catheter ablation: a two-phase translational study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Marco BergontiCardiology Department, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano 6900, Switzerland.ORCID 0000-0001-9864-1938
Mark T MillsLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, West Derby Street, Liverpool L7 8XL, UK.ORCID 0000-0002-5425-7739
Laurent RotenDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.ORCID 0000-0002-0827-1329
Martin H RuwaldDivision of Electrophysiology, Department of Cardiology, Herlev-Gentofte Hospital, Hellerup, Denmark.ORCID 0000-0002-1541-309X
Andreas MetznerDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID 0000-0002-6818-6396
Giulio ConteCardiology Department, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano 6900, Switzerland.ORCID 0000-0003-2248-3456
Maura M ZyllaDepartment of Cardiology, Heidelberg Center of Heart Rhythm Disorders, Medical University Hospital, Im Neuenheimer Feld 410, Heidelberg, Germany.ORCID 0000-0001-9373-8132
Konstantinos VlachosIHU LIRYC ANR-10-IAHU-04, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France.ORCID 0000-0002-7543-3236
Michal MazurekDepartment of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Zabrze, Poland.ORCID 0000-0002-1991-1707
Laura PerrottaArrhythmia Unit, Department of Cardiology, Careggi University Hospital, Florence, Italy.ORCID 0000-0002-4322-1183
Piotr FutymaMedical College, University of Rzeszów and St. Joseph's Heart Rhythm Center, Rzeszów, Poland.ORCID 0000-0003-0219-7612
Arian SultanDepartment of Electrophysiology, Heart Centre University Hospital Cologne, Cologne, Germany.ORCID 0000-0003-1807-4860
Christian-Hendrick HeegerDepartment of Rhythmology, Cardiology and Internal Medicine, Asklepios Klinik Hamburg Altona, Hamburg, Germany.ORCID 0000-0002-9014-8097
Julian K R ChunCardioangiologisches Centrum Bethanien, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany.ORCID 0000-0002-2355-6015

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPulsed field ablation (PFA) has rapidly emerged as a non-thermal ablation technology for pulmonary vein isolation (PVI), with an unprecedented adoption across Europe. The aim of this survey was to characterize current practice patterns. METHODS AND

resultsThe European Heart Rhythm Association (EHRA) Scientific Initiatives Committee designed a 30-item questionnaire addressing temporal adoption of PFA, pre-, intra-, and post-procedural workflows, and future perspectives. The survey was distributed between April and June 2025. A total of 216 responses were obtained from 43 countries. At the time of the survey, 23% of respondents had not yet initiated a PFA programme. Overall, PFA is now used in half (49%) of first atrial fibrillation (AF) ablation procedures. Adoption was significantly higher in high-volume centres and 'Western European' countries. The primary driver for adoption was time efficiency (60%). Intra-procedural workflows showed marked heterogeneity: approximately half of the operators relied exclusively on fluoroscopy without any intra-procedural imaging/mapping. Additional ablation lesions beyond PVI were common, with one-third employing standardized PVI+ protocols in persistent AF, most frequently posterior wall isolation. General anaesthesia and deep sedation were used in equal proportions.

conclusionThis EHRA survey demonstrates both rapid implementation and significant heterogeneity in PFA use across Europe. Standardized protocols and prospective studies are needed to define best practices.

Indexed as

Atrial FibrillationCatheter AblationPractice Patterns, Physicians'Pulmonary VeinsEuropeHealth Care SurveysHumansTreatment OutcomeWorkflowAblationAtrial fibrillationPulmonary vein isolationPulsed field ablation

Identifiers

PMID41363248
PMCPMC12686987

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.